Informed Consent

Obtaining consent is an ongoing communication process, not a onetime event. Its purpose is to provide information to enable patients to make informed decisions/choices about accepting/refusing proposed treatment. The consent process should include an explanation of the diagnosis and recommended treatment including: benefits, risks and other options for treatment. It is important that patients understand the nature/purpose of what is being proposed and have an opportunity to ask questions or get further clarification if required. The process is further helped by communicating to patients in plain, easy to understand language—technical terms or jargon is not recommended.

Informed consent is an ongoing process and must be based on a careful discussion of relevant information and considerations regarding a proposed treatment.

Patients must:

Understand nature/purpose of treatment;

Be informed why treatment should be performed;

Be given reasonable and understandable answers to any questions about treatment;

Be informed of reasonable alternatives to proposed treatment;

Be advised of treatment’s impact on lifestyle, if any;

Be informed of any economic considerations of receiving or refusing proposed treatment;

Be acquainted with potential risks/odds of risk occurring;

Be advised of consequences of refusing treatment.

Canadian law requires that patients be informed of the risks (attendant, material and special) associated with a given treatment: Attendant risks - those that are more common. Material risks – those that are less common but serious should they happen. Material risks can differ between patients. Special risks - include probable and possible relevance to a particular person.

When determining whether informed consent was established, the law asks whether the average, reasonable person in the patient’s position would consent to the treatment knowing the attendant, material and special risks.

Probable attendant risks, material and special risks should be disclosed.

Different strategies may be needed to ensure patient understanding including:

Expressed consent - can be written or verbal. As a general rule, the law does not require ‘written consent,’ however; written consent is more precise and prudent and provides clear evidence of consent.

Implied consent – can be implied from a patient’s words or actions e.g., consent is implied when a patient presents themselves for physiotherapy treatment.

Documentation should reﬂect the consent process and when/how consent is obtained.

A signed consent form can provide evidence that informed consent was obtained, but cannot replace a detailed discussion of the relevant information.

Different strategies may and should be used to ensure patient understanding (given the circumstances) including: verbal explanations, handouts, visual aids, consent forms, asking a patient whether they understand the information presented; providing updates and report throughout the course of service.